Provider Demographics
NPI:1770713752
Name:AGUILAR, ROCHELLE ROBYN (LCSW)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:ROBYN
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:ROBYN
Other - Last Name:ATENCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2921 CARLISLE BLVD NE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2850
Mailing Address - Country:US
Mailing Address - Phone:505-888-9769
Mailing Address - Fax:505-717-2988
Practice Address - Street 1:2921 CARLISLE BLVD NE STE 101
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2850
Practice Address - Country:US
Practice Address - Phone:505-888-9769
Practice Address - Fax:505-717-2988
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-083751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM53782755Medicaid